Endoscopic skin-graft urethroplasty

Area of Science:

• Urology
• Regenerative Medicine
• Surgical Innovation

Background:

• Urethral strictures pose significant challenges, often requiring complex reconstructive surgery.
• Current treatments like optical urethrotomy have limitations in long-term efficacy, while tissue-graft urethroplasty can be invasive.

Purpose of the Study:

• To develop and evaluate a minimally invasive treatment for urethral strictures.
• To combine the benefits of optical urethrotomy with the durability of tissue-graft urethroplasty.
• To assess the efficacy and long-term outcomes of a novel graft-holding instrument.

Main Methods:

• Development of purpose-specific instruments for precise graft placement.
• Optical urethrotomy followed by implantation of a full-thickness penile skin graft.
• Follow-up of 53 patients for at least 2 years post-procedure.

Main Results:

• An overall graft take rate of 95% was achieved.
• 100% urethral patency was observed at 2 years for inflammatory and iatrogenic strictures.
• Patency rates of 50% and 75% were noted for pelvic fracture-related and delayed trauma strictures, respectively.

Conclusions:

• The combined approach offers a promising, minimally invasive solution for urethral strictures.
• High graft take and sustained urethral patency support the long-term effectiveness of this technique.
• Further research may refine outcomes for complex stricture etiologies.